Department of Inclusive Medicine, University Hospital Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany.
Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany.
J Intellect Disabil Res. 2024 Dec;68(12):1374-1385. doi: 10.1111/jir.13183. Epub 2024 Aug 25.
The increasing life expectancy of individuals with Down syndrome has led to a growing awareness of mid- and late-life conditions.
Based on the Disease Analyser database (IQVIA), this retrospective cohort study compared adults ≥18 years of age with Down syndrome (ICD-10: Q90) in general practices in Germany with a propensity score-matched cohort without Down syndrome. The outcome was the first diagnosis of a fracture within 5 years of the index date. The cumulative incidence of fractures over a 5-year period was presented using Kaplan-Meier curves. Univariable Cox regression analyses by age group and sex were performed to assess the association between Down syndrome and fractures.
A total of 2547 individuals with Down syndrome and 12 735 individuals without Down syndrome were included in the study. A significantly higher cumulative fracture incidence within 5 years was observed in the age group 51-60 years (9.3% Down syndrome vs. 4.8% without Down syndrome, P = 0.003) as well as in the age group >60 years (20.3% Down syndrome vs. 8.6% without Down syndrome, P < 0.001) compared with the cohort without Down syndrome. Regression analysis showed a significant association between Down syndrome and fracture risk in women with Down syndrome aged 51-60 years (hazard ratio [HR] = 1.60; 95% confidence interval [CI]: 1.13-2.26), and in those aged 51-60 years (HR = 2.08; 95% CI: 1.27-3.41) and >60 years (HR = 2.98; 95% CI: 1.87-4.73)), but not in men. When comparing fractures in individuals with and without Down syndrome, shoulder and arm fractures were most common in the Down syndrome cohort.
The results of our study indicate a positive association between individuals with Down syndrome and subsequent fractures in women and those aged >50 years. Prevention of falls appears to be particularly important in these populations. However, future studies should clarify the extent to which socio-economic factors, such as housing, play a role in this context.
唐氏综合征患者的预期寿命不断延长，导致人们对中年和晚年的疾病日益关注。
本回顾性队列研究基于 IQVIA 的疾病分析数据库，将德国普通诊所中年龄≥ 18 岁的唐氏综合征患者（ICD-10：Q90）与无唐氏综合征的倾向评分匹配队列进行比较。主要结果为指数日期后 5 年内首次确诊骨折。通过 Kaplan-Meier 曲线呈现 5 年内骨折的累积发生率。采用单变量 Cox 回归分析按年龄组和性别评估唐氏综合征与骨折之间的关联。
共纳入 2547 名唐氏综合征患者和 12735 名无唐氏综合征患者。与无唐氏综合征的队列相比，在 51-60 岁年龄组（唐氏综合征 9.3% vs. 无唐氏综合征 4.8%，P=0.003）和>60 岁年龄组（唐氏综合征 20.3% vs. 无唐氏综合征 8.6%，P<0.001）中，5 年内骨折的累积发生率明显更高。回归分析显示，51-60 岁女性唐氏综合征患者骨折风险与唐氏综合征显著相关（风险比 [HR] = 1.60；95%置信区间 [CI]：1.13-2.26），51-60 岁（HR = 2.08；95% CI：1.27-3.41）和>60 岁（HR = 2.98；95% CI：1.87-4.73）），但男性无此关联。比较唐氏综合征患者和无唐氏综合征患者的骨折情况，唐氏综合征患者中肩部和手臂骨折最常见。
本研究结果表明，唐氏综合征患者与女性和>50 岁人群的后续骨折存在正相关。在这些人群中，预防跌倒似乎尤为重要。然而，未来的研究应明确社会经济因素（如住房）在这方面的作用程度。
